3rd. Int. Conference of StepsLidingö, 15th - 18th of May 2003

"Organisation Developement"

At the 3rd. International Conference in Lidingö we would like to work out clear and practical
recommendations concerning the organisational structure of services in learning disabilities. Frame of
reference for recommendations are the UN-Standard rules on equalisation of opportunities for people with
disabilities and the EU-Charter of Civil Rights.

To continue the discussions at the Rotterdam Conference we will focus on four crucial topics in organising
services on a community level to collect the knowledge and diversity represented in the expert network of
STEPS and to formulate recommendations.

The four topics should cover four levels of organisation:

the macro-level of service structures

the internal structures of the service institutions

the relationship to the community and

self-determination of service users.

How to achieve this aim?

The Conference will be subdivided in four plenary sessions. Each a member of the STEPS-network will be asked to
take the chair of one session. The chair would be responsible to focus and concentrate the presentations and
discussion on central recommendations concerning the session's topic.

Each session will be opened by three presentations coming from different countries. Each presentation should
take maximum 20 minutes and should be handed out in advance in an English version.

The four sessions will be introduced by Lars Lööw, Disability Ombudsman of Sweden, with his presentation
"Services for learning disabilities according to the human rights - tasks, problems and Steps forward."

Session I: Macro-level of Service Structures: Mainstreaming, synergism or specialisation?

Abstract:
Learning disability services comprise regular health services, rehabilitation, daily care and support in
housing, assistance to work, therapy etc. The services in the five STEPS-countries are organised in very
different ways.

This session focuses on the macro-level of service structures. Recommendations concerning appropriate ways of
organising services to meet peoples needs should be formulated:

Do we need specialised services, joint services or community based health and care centres?

Which services provide equal access? Are there obstacles to mainstream services?

How could a complex social welfare and health system be developed in user-friendly services?

Which services provide a good risk-management?

These are only some questions to show the significance of the topic of "Macro-level of Service Structures -
mainstreaming, synergism or specialising?".

Users with severe learning disabilities and users with severe health or psychiatric indications should be
taken in consideration as well as users with mild disabilities.

Abstract:
In STEPS, there are different kinds of organisations represented: from huge trusts, traditional
"stichtings" (foundations) to community based services.

This session should focus on appropriate organisational structures in service providing organisations.
In the face of economic pressure, European developments and rationalisation the providers tend to build
big trusts and holdings.

Are they appropriate to the users and do they meet the requirements of community based services?

Which structures guarantee the fulfilment of human rights?

"Small is beautiful", was a slogan in the 80th. Is it still relevant or are cluster-trusts a
new way to provide individual services, clustering smaller units under one roof?

Abstract:
Services based on the Human Rights demand regional, local structures and a tolerant and integrative
community and neighbourhood. Thus community development and community involvement are required from
service providing organisations and local authorities/administrations as well as from
community networks.

How could service providing organisations co-operate with the community, the families and neighbourhoods?

What could the organisations bring in the community?

How could they increase the acceptance of the people with learning disabilities in the community
to reduce the risk for them?

This session should recommend useful methods and structural elements. It should focus on attitudes and
structures to open the service providers to the community, involved in neighbourhood building and
encouraging inclusion.

This session should recommend service structures capable of supporting community in a double sense of
community living.

Abstract:
This session should focus on person centred user support to get adequate services according to the
person's needs and wishes and to control the service providing organisations. The user should be
empowered to claim personal integrity and dignity and to fight for his or her rights.

How could equal access to services be guaranteed to different user-groups (ethnic minorities, women, homosexuals)?

Wow could cultural identity and self-determination be safeguarded and supported in the services?

Do we need independent advocats or do they already exist?

How could they receive and maintain necessary influence and power?

Does advocacy increase costs and the complexity of service structures or the number of professionals?

Is it possible to control local authorities/administrations and service providing organisations according to human rights?

We want to get a recommendation towards a clear understanding of person centred user support
in a strict sense.